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Léda-Rêgo G, Studart-Bottó P, Sarmento S, Cerqueira-Silva T, Bezerra-Filho S, Miranda-Scippa Â. Psychiatric comorbidity in individuals with bipolar disorder: relation with clinical outcomes and functioning. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01562-5. [PMID: 36725737 DOI: 10.1007/s00406-023-01562-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 01/17/2023] [Indexed: 02/03/2023]
Abstract
The aim was to assess the lifetime prevalence of psychiatric comorbidity (PC) in Brazilian euthymic individuals with bipolar disorder type I, and investigate its effects on clinical outcomes and functioning. A group of 179 outpatients with BD-I in the recuperation phase were assessed, of whom 75 (41.9%) had PC and 104 (58.1%) had not. Both groups were compared using sociodemographic/clinical questionnaire, Structured Clinical Interview for DSM-IV axis I and II, Sheehan Disability and Barratt Impulsiveness Scales. Patients with PC presented less religious affiliation, more history of lifetime psychotic symptoms, rapid cycling, suicide attempts, worse scores of functioning, and higher prevalence of personality disorders. Ordinal logistic regression indicated that PC was associated with increased odds of worse levels of disability. Therefore, it could be observed that patients with BD evaluated only in euthymia presented a high mental disorders comorbidity. Considering their burdensome impact, appropriate management is a challenging reality and a crucial factor in reducing morbidity and mortality associated with BD. Further longitudinal studies on their relationship may broaden interventions to reduce patient's suffering.
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Affiliation(s)
- Gabriela Léda-Rêgo
- Mood and Anxiety Disorders Program (CETHA), Federal University of Bahia (UFBA), Salvador, BA, Brazil. .,Postgraduate Program in Medicine and Health, UFBA, Salvador, BA, Brazil.
| | - Paula Studart-Bottó
- Mood and Anxiety Disorders Program (CETHA), Federal University of Bahia (UFBA), Salvador, BA, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, BA, Brazil
| | - Stella Sarmento
- Mood and Anxiety Disorders Program (CETHA), Federal University of Bahia (UFBA), Salvador, BA, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, BA, Brazil
| | | | - Severino Bezerra-Filho
- Mood and Anxiety Disorders Program (CETHA), Federal University of Bahia (UFBA), Salvador, BA, Brazil
| | - Ângela Miranda-Scippa
- Mood and Anxiety Disorders Program (CETHA), Federal University of Bahia (UFBA), Salvador, BA, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, BA, Brazil.,Department of Neurosciences and Mental Health, Medical School, UFBA, Salvador, BA, Brazil
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Studart-Bottó P, Bezerra-Filho S, Sarmento S, Miranda-Scippa Â. Social support in patients with bipolar disorder and differing ages at onset. Clin Psychol Psychother 2021; 29:351-359. [PMID: 34128280 DOI: 10.1002/cpp.2617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The main purpose of this study was to evaluate the association between age at onset and social support in outpatients with bipolar disorder who were in the recovery phase. We also investigated the association between age at onset and disability. METHODS A total of 180 bipolar disorder I outpatients, of whom 50 had early onset with age at onset ≤18 years old, 108 had middle onset with age at onset between 19 and 39 years old, and 22 had late onset with age at onset ≥40 years old, were assessed with the Medical Outcomes Study Social Support Scale and Sheehan Disability Scale. RESULTS The early onset group had lower tangible social support, longer length of illness, more childless participants, lower income and more suicide attempters than the late onset group. CONCLUSIONS Early onset seems to have inferior outcomes in tangible social support than late onset, but this trend should be considered as a starting point for future studies.
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Affiliation(s)
- Paula Studart-Bottó
- Mood and Anxiety Disorders Program (CETHA), University Hospital, Federal University of Bahia (UFBA), Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil
| | - Severino Bezerra-Filho
- Mood and Anxiety Disorders Program (CETHA), University Hospital, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Stella Sarmento
- Mood and Anxiety Disorders Program (CETHA), University Hospital, Federal University of Bahia (UFBA), Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil
| | - Ângela Miranda-Scippa
- Mood and Anxiety Disorders Program (CETHA), University Hospital, Federal University of Bahia (UFBA), Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil.,Department of Neurosciences and Mental Health, Medical School, UFBA, Salvador, Brazil
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Almeida VFD, Bezerra-Filho S, Studart-Bottó P, Léda-Rego G, Silva ITF, Kapczinski F, Miranda-Scippa Â. History of suicide attempts in patients with bipolar disorder type I: socio-demographic and clinical factors, quality of life and functioning. Nord J Psychiatry 2021; 75:306-313. [PMID: 33302763 DOI: 10.1080/08039488.2020.1853230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION This study aims to evaluate sociodemographic and clinical factors, quality of life (QoL) and functioning associated with history of suicide attempts (SA) in a sample of bipolar disorder (BD) type I patients. METHODS A total of 417 BD type I patients, with and without history of SA were recruited from two Brazilian specialized Mood Disorder Centers. They were assessed with a sociodemographic and clinical questionnaire, the Young Mania Rating Scale, the Hamilton Depression Rating Scale, the Structured Clinical Interviews for DSM-IV Axis I Disorders, the World Health Organization Quality of Life-BREF, and the Sheehan Disability Scale. RESULTS One hundred and seventy-nine (42.9%) patients had a history of SA. There were no statistically significant sociodemographic differences between BD patients with and without a history of SA. Logistic regression found that lifetime hospitalization, comorbid anxiety disorders, depressive polarity in the first episode, current intensity of depressive symptoms, history of rapid cycling, family history of suicide and age at onset were significantly associated with SA in BD. Multiple linear regression showed that SA had no effect on QoL and functioning, which were affected mainly by comorbid anxiety disorders and current intensity of depressive symptoms, even in patients considered euthymic. CONCLUSION Suicidal behavior in patients with BD is a complex phenomenon and reflects a more severe course of illness. Patients with history of SA may have worse QoL and functional impairment not because of its direct effect, but because of the greater association with clinical factors related to poor prognosis.
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Affiliation(s)
| | | | - Paula Studart-Bottó
- Mood and Anxiety Disorders Program (CETHA), UFBA, Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil
| | - Gabriela Léda-Rego
- Mood and Anxiety Disorders Program (CETHA), UFBA, Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil
| | | | - Flávio Kapczinski
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Ângela Miranda-Scippa
- Mood and Anxiety Disorders Program (CETHA), UFBA, Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil.,Department of Neurosciences and Mental Health, Bahia Medical School, UFBA, Salvador, Brazil
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Studart-Bottó P, Martins-Junior DF, Sarmento S, Argolo L, Galvão-de-Almeida A, Miranda-Scippa Â. Self-injurious behavior and related mortality in children under 10 years of age: a retrospective health record study in Brazil. Braz J Psychiatry 2020; 42:40-45. [PMID: 31389497 PMCID: PMC6986482 DOI: 10.1590/1516-4446-2018-0355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 04/23/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To describe and analyze data on self-injurious behavior (SIB) and related mortality in children under 10 years old in Brazil. METHODS A descriptive study was performed using secondary public health care data extracted from the Hospital Information System (Sistema de Informações Hospitalares, SIH) and Mortality Information System (Sistema de Informações sobre Mortalidade, SIM) in Brazil. The databases are available for online access at http://datasus.saude.gov.br/. RESULTS In Brazil, according to SIH data, 11,312 hospitalizations of patients under 10 years of age were recorded from 1998 to 2018 as resulting from SIB (ICD-10 X60-X84 codes). Of these, 65 resulted in death. According to the SIM, from 1996 to 2016, 91 deaths related to SIB were recorded, 81 (89%) in children aged 5 to 9 years, nine (9.9%) in children aged 1 to 4 years, and one (1.1%) in a child below 1 year of age. CONCLUSION These results highlight the relevance of creating measures to better understand SIB and related mortality in this age group. They also reveal the vulnerability of children in Brazil and warrant further studies to address these issues.
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Affiliation(s)
- Paula Studart-Bottó
- Ambulatório de Transtorno do Humor e Ansiedade (CETHA), Complexo Hospitalar Universitário Professor Edgard Santos (HUPES), Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
- Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brazil
| | - Davi F. Martins-Junior
- Ambulatório de Transtorno do Humor e Ansiedade (CETHA), Complexo Hospitalar Universitário Professor Edgard Santos (HUPES), Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
- Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brazil
- Departamento de Saúde, Universidade Estadual de Feira de Santana (UEFS), Feira de Santana, BA, Brazil
| | - Stella Sarmento
- Ambulatório de Transtorno do Humor e Ansiedade (CETHA), Complexo Hospitalar Universitário Professor Edgard Santos (HUPES), Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
| | - Lucas Argolo
- Ambulatório de Transtorno do Humor e Ansiedade (CETHA), Complexo Hospitalar Universitário Professor Edgard Santos (HUPES), Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
- Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brazil
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, BA, Brazil
| | - Amanda Galvão-de-Almeida
- Ambulatório de Transtorno do Humor e Ansiedade (CETHA), Complexo Hospitalar Universitário Professor Edgard Santos (HUPES), Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
- Departamento de Neurociência e Saúde Mental, Faculdade de Medicina, UFBA, Salvador, BA, Brazil
| | - Ângela Miranda-Scippa
- Ambulatório de Transtorno do Humor e Ansiedade (CETHA), Complexo Hospitalar Universitário Professor Edgard Santos (HUPES), Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
- Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brazil
- Departamento de Neurociência e Saúde Mental, Faculdade de Medicina, UFBA, Salvador, BA, Brazil
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